STUDY OF THE CLINICAL PROFILE OF HEPATIC ENCEPHALOPATHY IN TERTIARY CARE HOSPITAL

Abstract

Introduction Hepatic encephalopathy is the term used to describe the complex and variable changes in neuropsychiatric status that complicates liver disease.Aim- To study the clinical profile of Hepatic Encephalopathy. Objectives -To determine clinical spectrum of Hepatic Encephalopathy and to determine various etiologies precipitating Hepatic Encephalopathy. METHODS- Study area:- Department of medicine at Krishna Institute of Medical Sciences and research institute, Karad. Hospital based prospective, observational and non-interventional study. Patients having altered mental states and neurological impairments along with liver dysfunction present above 18 years. Exclusion Patients below 18 years of age,the patients with other known causes of encephalopathy like uremia, hypertensive encephalopathy, CVA, cerebral malaria, electrolyte disturbances will be excluded from the study. And Patients with underlying active brain diseases. Results 74 patients were enrolled, out of which 66 patients were males and 8 were females. Between the age group of 20 to 88 years with mean age of 50.16 with SD of 14.93.Anorexia (80%), yellowish of eyes (70%), altered sensorium (43.24%) and vomiting were the most widely recognized introducing manifestations in patients with acute hepatic encephalopathy whereas yellow discoloration of eyes (84%) and altered mentation (43.24%) were present with chronic hepatic encephalopathy.On general examination, Icterus, pallor, oedematous feet and ecchymosis were seen in patients with acute hepatic encephalopathy while spider naevi, oedematous feet, palmer erythema, testicular atrophy and Dupuytren’s contractures were seen in patients of chronic encephalopathy.On per abdominal examination, patients with acute hepatic encephalopathy characteristically had hepatomegaly whereas, ascites and dilated veins were seen in those with chronic encephalopathy.History of alcoholism, previous jaundice, Hepatitis B surface antigen,history of previous blood transfusion, Hepatitis C antibody was the most common risk factors for hepatic encephalopathy.Among, clinical features parotid fullness (93.24%) was most common followed by finger clubbing (40.45%), liver palms (40.45%), spider naevi (17.56%), shrunken liver (13.51%) and gynecomastia (9.45%).At the time of admission, most common complications were Ascites (64.86%) followed by altered mentation (43.24%), renal failure (39.18%) and bleeding Diathesis (12.16%).